Withania Natural Health, SC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

WITHANIA NATURAL HEALTH, SC

Practice address

820 E Terra Cotta Ave Ste 215
Crystal Lake, IL 60014-3646

Phone

(779) 220-0208

Fax

(779) 220-0849

NPI assigned

Nov 11, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kelsey Louise Botterman, DC, ND

Title

Owner, Physician

Phone

(779) 220-0208

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1605052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605052800000",
    "number": "1649872003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 E TERRA COTTA AVE STE 215",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143646",
            "telephone_number": "779-220-0208",
            "fax_number": "779-220-0849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E TERRA COTTA AVE STE 215",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143646",
            "telephone_number": "779-220-0208",
            "fax_number": "779-220-0849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WITHANIA NATURAL HEALTH, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-11",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A",
        "authorized_official_last_name": "BOTTERMAN",
        "authorized_official_first_name": "KELSEY",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OWNER, PHYSICIAN",
        "authorized_official_telephone_number": "779-220-0208",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, ND"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.